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2016-02-11T12:53:09.36Z

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Biography information for Lord Prior of Brampton

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To ask Her Majesty’s Government, further to the Written Answers by Lord Prior of Brampton
on 11 and 12 February (HL5764 and HL5766) and by Baroness Neville-Rolfe on 11 February
(HL5765), and in the light of current information about the increased extent of dangers
from the Zika virus affecting up to 20 per cent of all births, whether they intend
to issue further advice about, or to reconsider, in consultation with other European
governments, the long-term implications of participating in or attending the 2016
Olympic Games in Brazil.

<p>The British Olympic Association (BOA) and British Paralympic Association (BPA)
have prepared guidance to consider the health risks, including those posed by Zika,
for British athletes and staff travelling to Brazil for the Olympics.</p><p> </p><p>The
Department of Health has convened an Olympics health advisory group on behalf of the
Department for Culture, Media and Sport to focus on Zika and to support the BOA and
BPA to ensure that they can continue to provide the best possible information and
advice.</p><p> </p><p>The group will be chaired by the Department’s Chief Scientific
Advisor, Professor Chris Whitty, and will bring together experts from the BOA and
BPA as well as the London School of Hygiene and Tropical Medicine, University of Liverpool,
University of Nottingham, the Royal Free London, Public Health England and across
Government.</p><p> </p><p>Revisions of existing guidance or specific further advice
will be published if it is deemed necessary.</p><p> </p><p>In the meantime, Public
Health England and the National Travel Health Network and Centre (NaTHNaC) have developed
and issued more general travel advice online to health professionals that is suitable
for people travelling to Zika-affected countries, including pregnant women. A copy
of the online advice is attached.</p><p> </p><p>This includes a list of countries
where Zika virus transmission is occurring, advice around bite avoidance measures
and what and who to speak to if those travelling have concerns. PHE and NaTHNaC continue
to monitor the situation very closely and update advice as needed.</p>

To ask Her Majesty’s Government what assessment they have made of the case for more
resources to be made available for specialist support models for people with complex
support needs, and who do not benefit from the Work and Health Programme.

<p>The Government recognises the challenges of helping those with the most complex
health conditions move closer to work. The new Personal Support Package announced
in <em>Improving Lives: The Work, Health and Disability </em>Green Paper introduces
a range of new measures and interventions designed as part of a package of support
which can be tailored to people’s individual needs. The offer, which applies to all
Employment and Support Allowance claimants (and Universal Credit equivalents), includes
personal support from disability trained, accredited work coaches, with a focus on
mental health. Work coaches will be supported by an additional 300 Disability Employment
Advisers and around 200 new community partners with disability expertise and local
knowledge. This will lead to better signposting to other local voluntary and public
sector services that may be available. A copy of the Green Paper is attached.</p><p>
</p><p>The Government recognises that more needs to be done to help people stay well
at work, including those with complex health conditions. The consultation on the Green
Paper will help us to consider appropriate new models of support to help more people
with disabilities or long term conditions to enter and remain in work.</p>

<p>In August 2015, NHS England published <em>Safer, faster, better: good practice
in delivering urgent and emergency care. </em>A copy is attached. This provides guidance
to help frontline providers and commissioners re-design urgent and emergency care
services, including considering locating urgent care centres in emergency departments.</p><p><em>Safer,
faster, better</em> notes that urgent care centres co-located with emergency departments
provide an opportunity to stream patients with less serious illnesses and injuries
to a service that is resourced to meet their needs, while reducing crowding in emergency
departments. It also sets out that to preserve flow, urgent care centre staff and
cubicles must wherever possible be entirely separated from the majors/admission stream
and that where urgent care centres are co-located with emergency departments, there
must be appropriate integration, with shared governance arrangements and clearly defined
protocols for the two-way transfer of patients.</p>

To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton
on 8 November (HL2865), what steps have been taken to encourage joined up working
by local authorities, the National Health Service and responsible health agencies,
and local public health services to improve the health outcomes of Gypsies and Travellers.

<p>The <em>NHS Five Year Forward View</em> (2014) sets out the ambition to improve
the nation’s health and reduce inequalities, including among the most vulnerable groups.
Through the inequality duties introduced through the 2012 Health and Social Care Act,
local areas must have regard to inequalities in access to, and the outcomes from,
National Health Service services in developing their plans. Clinical commissioning
groups (CCGs), health and wellbeing boards and the rest of the local health system
work together to undertake joint strategic needs assessments of local health needs
and develop strategic plans, working with key stakeholders to deliver outcomes and
reduce health inequalities. <strong> </strong></p><p> </p><p>All CCGs are provided
with local and national data from Public Health England and NHS England to support
the planning and commissioning process. These tools help to identify differences in
access to services and health outcomes across the local population, including among
vulnerable groups. For example, on-line resources available to local areas include
Commissioning for Value Packs, the NHS Atlas of Variation in Healthcare, and the Marmot
indicator local authority profiles.</p><p> </p><p>Guidance on addressing the health
needs of vulnerable groups including Gypsies and Travellers was developed under the
DH-sponsored inclusion health programme. It included <em>Inclusion of Gypsy Traveller
health needs in Joint Strategic Needs Assessments: A review</em>, a report compiled
by Friends, Families and Travellers (2015), <em>Standards for commissioners and service
providers</em>, by the Faculty for Homeless and Inclusion Health (2013) and <em>Improving
access to health care for Gypsies and Travellers, homeless people and sex workers</em>,
by Royal College of General Practitioners (2013). Copies of these documents are attached.
NHS England published guidance for the service on the rights of vulnerable groups
in registering with GPs to reduce the risk of exacerbating health inequalities for
vulnerable groups, <em>Patient Registration: Standard Operating Principles for Primary
Medical Care (General Practice)</em>, NHS England, 2015. A copy has been placed in
the library.</p><p> </p>

To ask Her Majesty’s Government whether NHS England’s stillbirth care bundle will
be reviewed to assess whether it is having an impact on reducing stillbirths among
multiple pregnancies; and what plans they have to update it if further improvements
are required.

<p>The <em>Saving Babies Lives care bundle</em> covers all types of pregnancy, including
multiple pregnancies. The care bundle will be evaluated so that it can be developed
and refined to ensure that it continues to reflect best practice.</p><p> </p><p>The
Maternity Transformation Programme Board will drive forward the implementation of
the National Maternity Review, <em>Better Births</em>, published in February this
year. It will also include work to reduce the rate of stillbirths, neonatal and maternal
deaths in England. The formation of the Board marks a clear step forward towards delivering
the vision laid out in the National Maternity Review, ensuring that key organisations
work together to improve maternity services. <em>Better Births</em> makes recommendations
on the use of data including the development of a set of national indicators to aid
data comparison. NHS England and its delivery partners are developing plans to implement
this and the report’s other recommendations, and as part of this are considering the
case for a national dashboard. A copy of both <em>Better Births</em> and the <em>Saving
Babies Lives</em> care bundle are attached.</p><p> </p><p>The Board held its first
meeting on 8 June 2016 and is chaired by Sarah-Jane Marsh, Chief Executive of Birmingham
Children’s Hospital and Birmingham Women’s Hospital. The Board members and the organisations
they represent are detailed in the following table.</p><p> </p><p>NHS England and
its delivery partners are developing plans to implement the vision set out in <em>Better
Births</em>, the report of the National Maternity Review. These plans are likely to
include commissioning guidance.</p><p> </p><table><tbody><tr><td><p>Person</p></td><td><p>Organisation</p></td></tr><tr><td><p>Sarah-Jane
Marsh</p></td><td><p>Chair</p></td></tr><tr><td><p>Jane Cummings</p></td><td><p>Senior
Responsible Officer, Chief Nursing Officer</p></td></tr><tr><td><p>Keith Willett</p></td><td><p>Deputy
Chair, Medical Director for Acute Care, NHS England</p></td></tr><tr><td><p>Matthew
Jolly</p></td><td><p>Clinical lead (obstetrics) / workstream lead (data)</p></td></tr><tr><td><p>Jacqueline
Dunkley-Bent</p></td><td><p>Clinical lead (midwifery)</p></td></tr><tr><td><p>Dame
Julia Cumberlege</p></td><td><p>Stakeholder Reference Group Chair / Clinical Commissioning
Group Improvement and Assessment Framework Panel Chair</p></td></tr><tr><td><p>Flora
Goldhill</p></td><td><p>Department of Health / workstream lead (best practice for
safer care)</p></td></tr><tr><td><p>Wendy Reid / Bill Irish</p></td><td><p>Health
Education England / workstream lead (workforce)</p></td></tr><tr><td><p>Viv Bennett</p></td><td><p>Public
Health England / workstream lead (public health)</p></td></tr><tr><td><p>Ruth May</p></td><td><p>NHS
Improvement (Director of Nursing)</p></td></tr><tr><td><p>Mike Durkin</p></td><td><p>NHS
Improvement (Director of Patient Safety)</p></td></tr><tr><td><p>Jimmy Walker</p></td><td><p>Care
Quality Commission</p></td></tr><tr><td><p>Lauren Hughes</p></td><td><p>NHS England
/workstream lead (local transformation)</p></td></tr><tr><td><p>James Sanderson</p></td><td><p>NHS
England / workstream lead (choice and personalisation)</p></td></tr><tr><td><p>Simon
Medcalf</p></td><td><p>NHS England / workstream lead (perinatal mental health)</p></td></tr><tr><td><p>Tom
Denwood</p></td><td><p>NHS Digital / workstream lead (technology)</p></td></tr><tr><td><p>Martin
Campbell</p></td><td><p>NHS England / workstream lead (pricing)</p></td></tr><tr><td><p>David
Richmond</p></td><td><p>Royal College of Obstetricians and Gynaecologists</p></td></tr><tr><td><p>Cathy
Warwick</p></td><td><p>Royal College of Midwives</p></td></tr><tr><td><p>Nigel Acheson</p></td><td><p>Regional
delivery lead / Regional Medical Director, South</p></td></tr><tr><td><p>Roz Lindridge</p></td><td><p>Clinical
Networks maternity lead / East Midlands Associate Director, Clinical Networks and
Senate</p></td></tr></tbody></table>

To ask Her Majesty’s Government who will be on the NHS England’s Maternity Transformation
Board, and whether they plan to introduce a national maternity dashboard to provide
analysis relating to both single and multiple pregnancies.

<p>The <em>Saving Babies Lives care bundle</em> covers all types of pregnancy, including
multiple pregnancies. The care bundle will be evaluated so that it can be developed
and refined to ensure that it continues to reflect best practice.</p><p> </p><p>The
Maternity Transformation Programme Board will drive forward the implementation of
the National Maternity Review, <em>Better Births</em>, published in February this
year. It will also include work to reduce the rate of stillbirths, neonatal and maternal
deaths in England. The formation of the Board marks a clear step forward towards delivering
the vision laid out in the National Maternity Review, ensuring that key organisations
work together to improve maternity services. <em>Better Births</em> makes recommendations
on the use of data including the development of a set of national indicators to aid
data comparison. NHS England and its delivery partners are developing plans to implement
this and the report’s other recommendations, and as part of this are considering the
case for a national dashboard. A copy of both <em>Better Births</em> and the <em>Saving
Babies Lives</em> care bundle are attached.</p><p> </p><p>The Board held its first
meeting on 8 June 2016 and is chaired by Sarah-Jane Marsh, Chief Executive of Birmingham
Children’s Hospital and Birmingham Women’s Hospital. The Board members and the organisations
they represent are detailed in the following table.</p><p> </p><p>NHS England and
its delivery partners are developing plans to implement the vision set out in <em>Better
Births</em>, the report of the National Maternity Review. These plans are likely to
include commissioning guidance.</p><p> </p><table><tbody><tr><td><p>Person</p></td><td><p>Organisation</p></td></tr><tr><td><p>Sarah-Jane
Marsh</p></td><td><p>Chair</p></td></tr><tr><td><p>Jane Cummings</p></td><td><p>Senior
Responsible Officer, Chief Nursing Officer</p></td></tr><tr><td><p>Keith Willett</p></td><td><p>Deputy
Chair, Medical Director for Acute Care, NHS England</p></td></tr><tr><td><p>Matthew
Jolly</p></td><td><p>Clinical lead (obstetrics) / workstream lead (data)</p></td></tr><tr><td><p>Jacqueline
Dunkley-Bent</p></td><td><p>Clinical lead (midwifery)</p></td></tr><tr><td><p>Dame
Julia Cumberlege</p></td><td><p>Stakeholder Reference Group Chair / Clinical Commissioning
Group Improvement and Assessment Framework Panel Chair</p></td></tr><tr><td><p>Flora
Goldhill</p></td><td><p>Department of Health / workstream lead (best practice for
safer care)</p></td></tr><tr><td><p>Wendy Reid / Bill Irish</p></td><td><p>Health
Education England / workstream lead (workforce)</p></td></tr><tr><td><p>Viv Bennett</p></td><td><p>Public
Health England / workstream lead (public health)</p></td></tr><tr><td><p>Ruth May</p></td><td><p>NHS
Improvement (Director of Nursing)</p></td></tr><tr><td><p>Mike Durkin</p></td><td><p>NHS
Improvement (Director of Patient Safety)</p></td></tr><tr><td><p>Jimmy Walker</p></td><td><p>Care
Quality Commission</p></td></tr><tr><td><p>Lauren Hughes</p></td><td><p>NHS England
/workstream lead (local transformation)</p></td></tr><tr><td><p>James Sanderson</p></td><td><p>NHS
England / workstream lead (choice and personalisation)</p></td></tr><tr><td><p>Simon
Medcalf</p></td><td><p>NHS England / workstream lead (perinatal mental health)</p></td></tr><tr><td><p>Tom
Denwood</p></td><td><p>NHS Digital / workstream lead (technology)</p></td></tr><tr><td><p>Martin
Campbell</p></td><td><p>NHS England / workstream lead (pricing)</p></td></tr><tr><td><p>David
Richmond</p></td><td><p>Royal College of Obstetricians and Gynaecologists</p></td></tr><tr><td><p>Cathy
Warwick</p></td><td><p>Royal College of Midwives</p></td></tr><tr><td><p>Nigel Acheson</p></td><td><p>Regional
delivery lead / Regional Medical Director, South</p></td></tr><tr><td><p>Roz Lindridge</p></td><td><p>Clinical
Networks maternity lead / East Midlands Associate Director, Clinical Networks and
Senate</p></td></tr></tbody></table>

<p>The <em>Saving Babies Lives care bundle</em> covers all types of pregnancy, including
multiple pregnancies. The care bundle will be evaluated so that it can be developed
and refined to ensure that it continues to reflect best practice.</p><p> </p><p>The
Maternity Transformation Programme Board will drive forward the implementation of
the National Maternity Review, <em>Better Births</em>, published in February this
year. It will also include work to reduce the rate of stillbirths, neonatal and maternal
deaths in England. The formation of the Board marks a clear step forward towards delivering
the vision laid out in the National Maternity Review, ensuring that key organisations
work together to improve maternity services. <em>Better Births</em> makes recommendations
on the use of data including the development of a set of national indicators to aid
data comparison. NHS England and its delivery partners are developing plans to implement
this and the report’s other recommendations, and as part of this are considering the
case for a national dashboard. A copy of both <em>Better Births</em> and the <em>Saving
Babies Lives</em> care bundle are attached.</p><p> </p><p>The Board held its first
meeting on 8 June 2016 and is chaired by Sarah-Jane Marsh, Chief Executive of Birmingham
Children’s Hospital and Birmingham Women’s Hospital. The Board members and the organisations
they represent are detailed in the following table.</p><p> </p><p>NHS England and
its delivery partners are developing plans to implement the vision set out in <em>Better
Births</em>, the report of the National Maternity Review. These plans are likely to
include commissioning guidance.</p><p> </p><table><tbody><tr><td><p>Person</p></td><td><p>Organisation</p></td></tr><tr><td><p>Sarah-Jane
Marsh</p></td><td><p>Chair</p></td></tr><tr><td><p>Jane Cummings</p></td><td><p>Senior
Responsible Officer, Chief Nursing Officer</p></td></tr><tr><td><p>Keith Willett</p></td><td><p>Deputy
Chair, Medical Director for Acute Care, NHS England</p></td></tr><tr><td><p>Matthew
Jolly</p></td><td><p>Clinical lead (obstetrics) / workstream lead (data)</p></td></tr><tr><td><p>Jacqueline
Dunkley-Bent</p></td><td><p>Clinical lead (midwifery)</p></td></tr><tr><td><p>Dame
Julia Cumberlege</p></td><td><p>Stakeholder Reference Group Chair / Clinical Commissioning
Group Improvement and Assessment Framework Panel Chair</p></td></tr><tr><td><p>Flora
Goldhill</p></td><td><p>Department of Health / workstream lead (best practice for
safer care)</p></td></tr><tr><td><p>Wendy Reid / Bill Irish</p></td><td><p>Health
Education England / workstream lead (workforce)</p></td></tr><tr><td><p>Viv Bennett</p></td><td><p>Public
Health England / workstream lead (public health)</p></td></tr><tr><td><p>Ruth May</p></td><td><p>NHS
Improvement (Director of Nursing)</p></td></tr><tr><td><p>Mike Durkin</p></td><td><p>NHS
Improvement (Director of Patient Safety)</p></td></tr><tr><td><p>Jimmy Walker</p></td><td><p>Care
Quality Commission</p></td></tr><tr><td><p>Lauren Hughes</p></td><td><p>NHS England
/workstream lead (local transformation)</p></td></tr><tr><td><p>James Sanderson</p></td><td><p>NHS
England / workstream lead (choice and personalisation)</p></td></tr><tr><td><p>Simon
Medcalf</p></td><td><p>NHS England / workstream lead (perinatal mental health)</p></td></tr><tr><td><p>Tom
Denwood</p></td><td><p>NHS Digital / workstream lead (technology)</p></td></tr><tr><td><p>Martin
Campbell</p></td><td><p>NHS England / workstream lead (pricing)</p></td></tr><tr><td><p>David
Richmond</p></td><td><p>Royal College of Obstetricians and Gynaecologists</p></td></tr><tr><td><p>Cathy
Warwick</p></td><td><p>Royal College of Midwives</p></td></tr><tr><td><p>Nigel Acheson</p></td><td><p>Regional
delivery lead / Regional Medical Director, South</p></td></tr><tr><td><p>Roz Lindridge</p></td><td><p>Clinical
Networks maternity lead / East Midlands Associate Director, Clinical Networks and
Senate</p></td></tr></tbody></table>

<p>Health Education England’s Induction and Refresher (I&amp;R) Scheme gives general
practitioners (GPs) who have retired the opportunity to return to general practice.
The scheme is also open to those who have taken a career break or spent time working
abroad.</p><p> </p><p>On 6 October 2016, NHS England set out the latest measures it
is implementing to help general practice cope with increasing demand, boosting GP
numbers and tackling burnout as part of the <em>General Practice Forward View</em>,
a copy of which is attached. This includes increased financial support, increased
practical support and making the process more flexible. For example, working to develop
a national framework so that suitably qualified and experienced doctors can be added
to the Medical Performers List without the need to complete the I&amp;R process.</p><p>
</p><p>On completion of the I&amp;R Scheme, GPs may take up a post as a salaried general
practitioner. There are model terms and conditions of service for a salaried general
practitioner, a copy of which is attached.</p>

<p>The Office for National Statistics (ONS) produces comparisons of UK productivity
with the G7 countries and some, but not all, EU member states. ONS statistics show
output per hour worked in the UK was 15.9% below the average for the rest of the G7
advanced economies in 2015; 22.7% below that in France; 26.7% below Germany and 22.2%
below the USA.</p><p>Please see attached tables for full details.</p>

To ask Her Majesty’s Government what steps they are taking to ensure that patient
groups and patients are consulted on decisions made regarding new treatments as part
of NHS England's prioritisation process for investing in specialised services.

<p>NHS England involves patients, patient groups and the public at numerous stages
of the process for developing clinical commissioning policies and service specifications
that may be subject to a process of relative prioritisation.</p><p> </p><p>Clinical
policies and service specifications are developed by Clinical Reference Groups (CRGs),
which are advisory groups and include patients and patient representatives in their
membership. Draft clinical policies and service specifications undergo a process of
testing with registered stakeholders before they are submitted for a full public consultation.
The CRG will consider the outcome of stakeholder testing and public consultation before
submitting the final proposed document to NHS England for the purpose of relative
prioritisation.</p><p> </p><p>Recommendations on the relative prioritisation of new
investments in specialised services are made by the Clinical Priorities Advisory Group,
which is independently chaired and which includes patient and public voice representatives
in its membership. ​</p><p><em> </em></p><p>NHS England held a public consultation
on <em>Developing a method to assist investment decisions in specialised commissioning
</em>between April and May 2016. NHS England’s response to the consultation can be
found attached.</p>